ABSTRACT
Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.
ABSTRACT
Objective To compare the clinical symptoms,endoscopic lesions,pathological histological changes,and H.pylori infection between children with bile reflux gastritis (BRG) and non BRG.Methods 287 cases of children with upper gastrointestinal symptoms were diagnosed with gastritis by gastroscopy.They included 58 cases of BRG and 229 cases of non-BRG.The clinical symptoms,endoscopic lesions,pathological histological changes,and H.pylori infection were compared between two groups,respectively.Results Between BRG and non-BRG groups,there werent statistically significant difference in the main clinical symptoms including abdominal pain,anorexia,nausea,and early satiety.Incidence of abdominal distension,vomiting,and hiccups was[84.5％ (49/58) vs 66.8％ (153/229),32.8％ (19/58) vs 17.9％ (41/229),and 29.3％ (17/58) vs 16.6％ (38/229)],respectively,with statistical significance (x2 =6.93,6.18,4.83,P ＜0.05).There weren(t) statistically significant difference in endoscopic lesions congestion,edema,and mucosal plaques between two groups.Incidence of endoscopic gastric erosions and bleeding of two groups was [37.9％ (22/58) vs 22.7％ (52/229),20.7％ (12/58) vs 10.0％ (23/ 229)],respectively; and BRG group was statistically higher than non-BRG group(x2 =5.60,4.90,P ＜ 0.05).For micronodular change,there were 13 cases (22.4％) in BRG group and 86 cases (37.6％) in Non-BRG group,and Non-BRG group was statistically higher than BRG group(x2 =4.69,P ＜ 0.05).For histopathological changes including epithelial cell degeneration,hyperplasia and lamina propria lymphocyte and neutrophil infiltration,there wasnt statistically significant difference between BRG and non-BRG groups.Incidence about pit extension and mucosal vascular expansion of two groups was [10.34％ (6/58) vs 3.1％ (7/229) and 31.0 ％ (18/58) vs 18.3 ％ (42/229)],respectively ; and BRG group was significantly higher than non-BRG group(x2 =5.97,4.51,P ＜ 0.05).There were 7 cases (12.1％) in BRG group and 55 cases (24.0％) about lamina propria lymphoid follicles,and Non-BRG group was significantly higher than BRG group (x2 =3.90,P ＜0.05).H.pylori positive rates were[22.41％ (13/58),and 40.17％ (92/ 229)],respectively.BRG group and non-BRG group were found statistically significant (x2 =6.29,P ＜0.05).Conclusions BRG children with the characteristic symptoms were abdominal distension,vomiting,and hiccup inverse.Endoscopic characteristic performance was gastric erosions,bleeding spots in antral mucosa changes apparently.Mucosal vascular expansion and pit extension may prompt gastric in children with duodenogastric reflux.H.pylori positive rates of those gastric in children with bile reflux were relatively low.The clinical features could help early diagnosis BRG and guide clinical treatment to improve the cure rate.